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General NPI Number Information
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NPI Number | 1275177560
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Entity Type | Organization
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Legal Business Name | TRAVELING MAMA ENTERPRISES, LLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 67 S LEWIS AND CLARK TRL
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City | WHITEHALL
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State | MT
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Zip | 59759-9547
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Country | US
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Telephone | 406-209-3995
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Fax | 406-451-0551
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Provider Business Mailing Address
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Address Line | 67 S LEWIS AND CLARK TRL
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City | WHITEHALL
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State | MT
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Zip | 59759-9547
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Country | US
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Telephone | 406-209-3995
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Fax | 406-451-0551
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Authorized Official
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Title or Position | OWNER
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Name | AMY HORNER
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Credential | MPH, RD, CLC, RDN
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Telephone | 406-209-3995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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